Appeals

The Appeals process is available to all members of the Public Service Health Care Plan. If you do not agree with Sun Life’s decision about your claim, you may send a letter of appeal to the Administration Authority for review.

All appeals must be submitted in writing. Depending on the nature of the appeal, you may be asked to provide additional information or supporting documentation.

The Appeals Committee of the PSHCP Board of Directors will review your appeal to determine whether your claim was processed in accordance with the provisions that govern the PSHCP, and that all administrative procedures have been followed to ensure appropriate individual coverage. Decisions are made in consideration of the individual circumstances of the appeal and in accordance with the provisions of the Plan.

Prior to submitting an appeal, you should make every effort to resolve the issue with Sun Life, Compensation or your pension office.